tetano
Editor, Senior Moderator
Minerva Urol Nefrol
. 2021 Jan 13.
doi: 10.23736/S0393-2249.20.04081-3. Online ahead of print.
Impact of chronic exposure to 5-alpha reductase inhibitors on the risk of hospitalization for COVID-19: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy)
Massimo Lazzeri[SUP] 1 [/SUP], Stefano Duga[SUP] 2 3 [/SUP], Elena Azzolini[SUP] 2 [/SUP], Vittorio Fasulo[SUP] 2 [/SUP], Nicol? Buffi[SUP] 2 3 [/SUP], Alberto Saita[SUP] 2 [/SUP], Giovanni Lughezzani[SUP] 2 3 [/SUP], Elvezia M Paraboschi[SUP] 2 3 [/SUP], Rodolfo Hurle[SUP] 2 [/SUP], Alessandro Nobili[SUP] 4 [/SUP], Maurizio Cecconi[SUP] 2 3 [/SUP], Giorgio Guazzoni[SUP] 2 3 [/SUP], Paolo Casale[SUP] 2 [/SUP], Rosanna Asselta[SUP] 2 3 [/SUP], Humanitas COVID-19 Task Force; The Humanitas Gavazzeni COVID-19 Task Force
Affiliations
Abstract
Background: There are sex differences in vulnerability to Coronavirus disease 2019 (COVID-19). The coronavirus S protein mediates viral entry into target cells employing the host cellular serine protease TMPRSS2 for S-protein priming. The TMPRSS2 gene expression is responsive to androgen stimulation and it could partially explain sex differences. We hypothesized that men chronically exposed to 5-alpha reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) have a lower risk of hospitalization for COVID-19.
Methods: This is a population-based case-control study on consecutive patients positive for SARS-CoV-2 virus who required hospitalization for COVID-19 (cases), age-matched to beneficiaries of the Lombardy Regional Health Service (controls). Data were collected by two high-volume COVID-19 regional centers of Lombardy (Italy). The primary outcome was to compare the prevalence of patients chronically exposed to 5ARIs, who required hospitalization for COVID-19, with the one of controls.
Results: Overall, 943 males were enrolled; 45 (4.77%) were exposed to 5ARI. COVID-19 patients aged >55 years under 5ARI treatment were significantly less than expected on the basis of the prevalence of 5ARI treatment among age-matched controls (5.57 vs. 8.14%; p=0.0083, 95%CI=0.75-3.97%). This disproportion was higher for men aged >65 (7.14 vs. 12.31%; p=0.0001, 95%CI=2.83-6.97%). Eighteen 5ARIs-patients died; the mean age of men who died was higher than those who did not: 75.98?9.29 vs. 64.78?13.57 (p<0.001). Cox-regression and multivariable models did not show correlation between 5ARIs exposure and protection against intensive care unit admission/death.
Conclusions: Men exposed to 5ARIs might be less vulnerable to severe COVID-19, supporting its use in disease prophylaxis.
. 2021 Jan 13.
doi: 10.23736/S0393-2249.20.04081-3. Online ahead of print.
Impact of chronic exposure to 5-alpha reductase inhibitors on the risk of hospitalization for COVID-19: a case-control study in male population from two COVID-19 regional centers of Lombardy (Italy)
Massimo Lazzeri[SUP] 1 [/SUP], Stefano Duga[SUP] 2 3 [/SUP], Elena Azzolini[SUP] 2 [/SUP], Vittorio Fasulo[SUP] 2 [/SUP], Nicol? Buffi[SUP] 2 3 [/SUP], Alberto Saita[SUP] 2 [/SUP], Giovanni Lughezzani[SUP] 2 3 [/SUP], Elvezia M Paraboschi[SUP] 2 3 [/SUP], Rodolfo Hurle[SUP] 2 [/SUP], Alessandro Nobili[SUP] 4 [/SUP], Maurizio Cecconi[SUP] 2 3 [/SUP], Giorgio Guazzoni[SUP] 2 3 [/SUP], Paolo Casale[SUP] 2 [/SUP], Rosanna Asselta[SUP] 2 3 [/SUP], Humanitas COVID-19 Task Force; The Humanitas Gavazzeni COVID-19 Task Force
Affiliations
- PMID: 33439572
- DOI: 10.23736/S0393-2249.20.04081-3
Abstract
Background: There are sex differences in vulnerability to Coronavirus disease 2019 (COVID-19). The coronavirus S protein mediates viral entry into target cells employing the host cellular serine protease TMPRSS2 for S-protein priming. The TMPRSS2 gene expression is responsive to androgen stimulation and it could partially explain sex differences. We hypothesized that men chronically exposed to 5-alpha reductase inhibitors (5ARIs) for benign prostate hyperplasia (BPH) have a lower risk of hospitalization for COVID-19.
Methods: This is a population-based case-control study on consecutive patients positive for SARS-CoV-2 virus who required hospitalization for COVID-19 (cases), age-matched to beneficiaries of the Lombardy Regional Health Service (controls). Data were collected by two high-volume COVID-19 regional centers of Lombardy (Italy). The primary outcome was to compare the prevalence of patients chronically exposed to 5ARIs, who required hospitalization for COVID-19, with the one of controls.
Results: Overall, 943 males were enrolled; 45 (4.77%) were exposed to 5ARI. COVID-19 patients aged >55 years under 5ARI treatment were significantly less than expected on the basis of the prevalence of 5ARI treatment among age-matched controls (5.57 vs. 8.14%; p=0.0083, 95%CI=0.75-3.97%). This disproportion was higher for men aged >65 (7.14 vs. 12.31%; p=0.0001, 95%CI=2.83-6.97%). Eighteen 5ARIs-patients died; the mean age of men who died was higher than those who did not: 75.98?9.29 vs. 64.78?13.57 (p<0.001). Cox-regression and multivariable models did not show correlation between 5ARIs exposure and protection against intensive care unit admission/death.
Conclusions: Men exposed to 5ARIs might be less vulnerable to severe COVID-19, supporting its use in disease prophylaxis.